scholarly journals Assessment of Right Ventricular Function and Structure in Children with Idiopathic Dilated Cardiomyopathy

2021 ◽  
pp. 28-38
Author(s):  
Drahem Mansour Ahmed El-Fiky ◽  
Shimaa Basyony El-Nemr ◽  
Osama Abd Rab El-Rasoul Tolba ◽  
Waleed Ahmed El-Shahaby
Keyword(s):  
Left Ventricle ◽  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Tissue Doppler ◽  
Muscle Disease ◽  
Doppler Imaging ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Healthy Children

Background: Dilated cardiomyopathy (DCM) refers to dilating the ventricles and dysfunction of their systolic functions (predominantly the left ventricle) with or without congestive heart failure. In children, it is the most common form of heart muscle disease. We aimed to evaluate the right ventricular functions and structure using speckling tracking echocardiography in children with dilated cardiomyopathy and correlate this parameter with other echocardiographic findings. Methods: This observational Case-Control Study was carried out on 75 subjects. They were subdivided into two groups: Group 1: 50 patients with dilated cardiomyopathy Group 2: 25 healthy children matched for age and sex. Patients were evaluated by M-mode echocardiography, Transthoracic 2DE Examination (TTE), Tissue Doppler Examination (TDE) and Speckling Tracking Technique. Results: Left ventricle (LV) and right ventricle (RV) systolic dysfunction was evidenced by a significant decrease of mitral and tricuspid annular systolic velocities and a significant decrease of LV and RV global systolic strain and a significant decrease of LV and RV Ejection fraction (EF). LV and RV diastolic dysfunction were evidenced by a significant decrease of mitral and tricuspid annular diastolic velocities (E’/A’) and a significant increase of LV and RV Myocardial Perfusion Imaging (MPI). LV and RV global strains were significantly reduced in comparison to controls, suggesting that the dilated cardiomyopathy is a diffuse disease. Conclusion: In DCM patients, RV had significant systolic and diastolic dysfunction mainly elicited by the Tissue Doppler imaging (TDI) beside LV affection secondary to the interventricular interaction. TDI and 2D-STE add value to interpreting the findings and the dependency of RV systolic and diastolic functions on each other in DCM patients.

scholarly journals Echocardiographic Abnormalities in New-onset Polymyositis/dermatomyositis

2014 ◽  
Vol 42 (2) ◽  
pp. 272-281 ◽  
Author(s):  
Andrea Péter ◽  
Ágnes Balogh ◽  
Szabolcs Szilágyi ◽  
Réka Faludi ◽  
Melinda Nagy-Vincze ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Diastolic Dysfunction ◽  
Systolic Dysfunction ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Tricuspid Annulus ◽  
Mitral Inflow ◽  
Characteristic Values ◽  
Left And Right ◽  
Echocardiographic Findings

Objective.To identify early echocardiographic abnormalities at the time of diagnosis of polymyositis (PM) and dermatomyositis (DM) and follow the echocardiographic findings during the first 3 months of therapy.Methods.We included 30 PM/DM patients (23/7) with a mean age of 42.3 ± 1.6 years and without cardiovascular symptoms. Age-matched healthy patients served as controls. Clinical characteristics were recorded. Traditional echocardiography and tissue Doppler imaging (TDI) were performed to measure systolic [ejection fraction, right ventricular fractional area change (RV FAC), lateral and tricuspid annulus s velocities] and diastolic echocardiographic variables (mitral inflow velocities: E, A; deceleration time: DT; lateral and tricuspid annulus e′, a′ velocities, lateral E/e′).Results.The left and right ventricular systolic dysfunction detected by TDI at the time of the PM/DM diagnosis improved, and characteristic values at the end of the followup period were comparable to those of the controls (lateral s: 10.6 ± 0.2, 8.7 ± 0.4, 9.6 ± 0.3, 11.3 ± 0.2 cm/s; RV FAC: 45.2 ± 2.3, 36.9 ± 1.5, 42.2 ± 1.3, 46.9 ± 1.2%; tricuspid s: 13.3 ± 0.2, 9.5 ± 0.4, 10.3 ± 0.3, 11.6 ± 0.5 cm/s; control, 0, 1, and 3 mos, respectively). Measurements indicated the development of diastolic dysfunction at 3 mos (E/A: 1.4 ± 0.1, 1.29 ± 0.05, 1.03 ± 0.05, 0.92 ± 0.05; DT: 148.6 ± 3.6, 157.3 ± 5.7, 168.3 ± 6.0, 184.3 ± 6.2 ms; lateral e′: 12.8 ± 0.3, 12.1 ± 0.5, 10.2 ± 0.6, 10.8 ± 0.8 cm/s; E/e′: 5.6 ± 0.1, 5.0 ± 0.22, 6.92 ± 0.46, 7.64 ± 0.47; control, 0, 1, and 3 mos, respectively).Conclusion.TDI is a useful method to detect early cardiac abnormalities complementing the conventional echocardiographic measurements. LV and RV systolic dysfunction found in the acute phase significantly improved during the first 3 months of therapy; however, deterioration of diastolic dysfunction was also observed.

Diastolic dysfunction in patients with brucellosis despite the absence of infective endocarditis

2020 ◽  
Vol 30 (12) ◽  
pp. 1840-1843
Author(s):  
İbrahim Ece ◽  
Serdar Epçaçan ◽  
Gülsüm İclal Bayhan ◽  
Mehmet Türe
Keyword(s):  
Infective Endocarditis ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Diastolic Dysfunction ◽  
Tissue Doppler Imaging ◽  
Cardiac Involvement ◽  
Peak Velocity ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Healthy Children

AbstractBackground:Brucellosis is an important systemic infectious disease, especially in developing countries. Every organ and system of the human body can be affected; however, cardiovascular complications of brucellosis are rare.Aim:To assess cardiac functions in patients with acute brucellosis without overt cardiac involvement and to answer the following question: Is there any cardiac dysfunction despite the absence of endocarditis in these patients?Methods:This cross-sectional study included 67 children with brucellosis and 40 healthy children. We performed a detailed echocardiographic examination in individuals at the beginning of the treatment. Patients with infective endocarditis were excluded from the study.Results:Echocardiography revealed no difference of ejection fraction, mitral and tricuspid annular plane systolic excursion, pulsed-wave Doppler-derived early diastolic peak velocity (E)/late diastolic peak velocity (A) ratios in mitral and tricuspid valves between the two groups. The deceleration time of early mitral inflow was longer in patients with brucellosis. Early diastolic peak velocity of the mitral and tricuspid annuluses obtained by tissue Doppler imaging (Ea) was significantly lower in children with brucellosis. The peak velocity obtained by tissue Doppler imaging during late diastole (Aa), Ea and Ea/Aa ratios in the interventricular septum, left ventricle posterior wall and right ventricle free wall was lower in patients with brucellosis than in the control group. The E/Ea ratio, isovolumic relaxation time, right ventricle and left ventricle myocardial performance indices were higher in patients with brucellosis.Conclusion:Patients with acute brucellosis may have diastolic dysfunction without overt cardiac involvement and infective endocarditis.

scholarly journals Assessment of left atrial function by volumetric indices and tissue Doppler imaging in ischaemic and idiopathic dilated cardiomyopathy

2014 ◽  
Vol 66 (1) ◽  
pp. 26-27
Author(s):  
Mohammad Abdulghani Abdulzaher ◽  
Wael Mohammad Atteia ◽  
Abdelmohsen Mostafa Abo-Alia ◽  
Abdelaziz Rizk Hassan ◽  
Mohey Mansour Alabbady
Keyword(s):  
Dilated Cardiomyopathy ◽  
Tissue Doppler Imaging ◽  
Left Atrial ◽  
Tissue Doppler ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Doppler Imaging ◽  
Idiopathic Dilated Cardiomyopathy

Abstract 3186: Right Ventricular Apical Pacing Impairs Left Ventricular Apical and Basal Rotation and Induces Apical-Basal Rotation Dyssynchrony

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Ken Matsuoka ◽  
Masami Nishino ◽  
Masahiko Hara ◽  
Shinpei Nakatani ◽  
Akihito Hashimoto ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Systolic Dysfunction ◽  
Pacemaker Implantation ◽  
Acute Effect ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Apical Rotation ◽  
Av Conduction ◽  
Basal Rotation

Backgrounds: Although right ventricular apical (RVA) pacing has been reported to result in asynchronous patterns of left ventricular (LV) contraction reducing the LV ejection fraction (EF), LV torsion in RVA pacing has been unknown. We hypothesized that RVA pacing impairs rotation of LV apex and base and synchrony between LV apical and basal rotation, leading to the reduction of LV torsion. Methods: We studied 30 adult patients with sick sinus syndrome who had undergone DDD pacemaker implantation. Right ventricular pacing leads were positioned at the right ventricular apex. Changing from the intrinsic AV conduction to RVA pacing, we assessed the acute effect on echocardiac parameters; LV EF, tissue Doppler imaging (TDI) derived intraventricular delay, LV rotation and torsion, and LV apical-basal rotation dyssynchrony. Results: Results were shown in a table . Changing from the intrinsic AV conduction to RVA pacing, LV EF reduced (P=0.0003) and TDI derived intraventricular delay prolonged (P<0.0001). During RVA pacing, values of peak rotation in LV apex and LV base were significantly lower than those during intrinsic AV conduction (P=0.007 and 0.003, respectively). Correspondingly, LV torsion decreased significantly (P<0.0001). During the intrinsic AV conduction, LV apex and base rotated at the almost same time, while, during RVA pacing, LV basal rotation was delayed as compared to LV apical rotation. Consequently, apical-basal rotation dyssynchrony during RVA pacing was significantly longer than that during the intrinsic AV conduction (P=0.02). Conclusion: RVA pacing decreases LV rotation and torsion and induces LV apical-basal rotation dyssynchrony, resulting in partially LV systolic dysfunction. Comparison between Intrinsic AV Conduction and RVA Pacing

scholarly journals Assessment of left atrial function by volumetric indices and tissue Doppler imaging in ischaemic and idiopathic dilated cardiomyopathy

2014 ◽  
Vol 66 (1) ◽  
pp. 2
Author(s):  
Mohammad Abdelghany Abdelzaher ◽  
Wael Mohammad Atteia ◽  
Abdelmohsen Mostafa Abo-Alia ◽  
Abdelaziz Rizk Hassan ◽  
Mohey Mansour Alabbady
Keyword(s):  
Dilated Cardiomyopathy ◽  
Tissue Doppler Imaging ◽  
Left Atrial ◽  
Tissue Doppler ◽  
Atrial Function ◽  
Left Atrial Function ◽  
Doppler Imaging ◽  
Idiopathic Dilated Cardiomyopathy

Early Detection Of Right Ventricular Diastolic Dysfunction By Pulsed Tissue Doppler Echocardiography In Iron Loaded Beta Thalassemia Patients

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3454-3454
Author(s):  
Amal El-Beshlawy ◽  
Hala Agha ◽  
Mona Mohamed Hamdy ◽  
Alaa Sobeih ◽  
Fatma Alzahraah ◽  
...  
Keyword(s):  
Early Detection ◽  
Right Ventricular ◽  
Diastolic Dysfunction ◽  
Serum Ferritin ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Beta Thalassemia ◽  
Group I ◽  
Ventricular Diastolic Dysfunction ◽  
Right Ventricular Diastolic Dysfunction

Abstract Introduction Iron overload contributes to cardiac dysfunction in patients with beta thalassemia. Early heart iron overload can be quantified through cardiovascular magnetic resonance (CMR) T2*. Objective to clarify the value of tissue Doppler imaging (TDI) in early detection of global myocardial dysfunction in iron loaded thalassemia major patients diagnosed by CMR. Patients and Methods Two groups were included in the study; Group I: 69 asymptomatic thalassemia patients (28 females, 41 males), mean age 18.1±7.03 years (range 6 to 39 years), Group II (n=41) healthy normal controls matched for age and sex. Serum ferritin and CMR were performed to assess the degree of cardiac siderosis (T2*< 20 ms). Group I was subdivided into two subgroups; Group Ia (n=26) T2*<20ms and Group Ib (n=43) T2* >20ms. Conventional echocardiography and Doppler of LV, RV dimensions and functions and pulmonary artery pressure were evaluated. TDI measures included systolic and diastolic myocardial velocities (S', E', A' and E'/A') of the basal segments of septal, lateral LV and RV free walls. Results Right ventricular diastolic function assessed by tricuspid annular E'/A' was positively correlated with T2* value; the lower tricuspid E'/A' ratio the lower T2* value (r = +0.366, P=0.002). Tricuspid annular A' was significantly higher in group Ia compared to group Ib (16.7 ±5.2cm/s versus 12.1 ±4.0cm/s, P<0.001). Tricuspid E'/A'<1 was common in group Ia compared to group Ib (19/26 (73.0%) versus 3/43 (6.97%), P=0.000). Group Ia (T2*<20ms) had high serum ferritin level compared to group Ib (T2*>20ms) (6,357±2478 microgram/L versus 2,965±2289 microgram/L (P<0.0001). By multivariate logistic regression analysis, right ventricular diastolic dysfunction (tricuspid E'/A'< 1) was associated with serum ferritin and T2* level of the thalassemic patient. Conclusion Pulsed tissue Doppler imaging (TDI) is a promising tool for quantitative assessment of myocardial function and early detection of right ventricular diastolic dysfunction in iron loaded beta thalassemia major patients assessed by cardiovascular magnetic resonance. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Comparison of cardiac dysfunction in thalassemia major patients using deferoxamine or deferiprone as an iron-chelating agent

2012 ◽  
Vol 52 (5) ◽  
pp. 272 ◽  
Author(s):  
Rosalina Josep ◽  
Pustika Amalia Wahidiiyat ◽  
Partini Trihono ◽  
Piprim Yanuarso
Keyword(s):  
Diastolic Dysfunction ◽  
Cardiac Dysfunction ◽  
Standard Dose ◽  
Systolic Dysfunction ◽  
Chelating Agent ◽  
Thalassemia Major ◽  
Iron Chelator ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Cross Sectional

Background In thalassemia major (TM) patients, major mortalityis due to cardiac hemosiderosis. Several types of iron chelatingagent available recently are given to overcome this problemObjective To compare cardiac dysfunction in thalassemia majorpatients who used subcutaneous deferoxamine (DFO) to thosewho used oral deferiprone (DFP) as an iron􀁆chelating agent.Methods This cross􀁆sectional study was held at the ThalassemiaCenter, Department of Child Health􀁆Cipto MangunkusumoHospital (DCH􀁆CMH), Jakarta. We included TM patients aged1O􀁆18 years Mth a mean pre􀁆transfused hemoglobin level of 2:.7g/dL in the prior year, and who had used DFO or DFP for atleast 1 year v.ith good compliance, at a standard dose of DFO at40-60 mg/kg/day for 5 days a week or DFP at 50-100 mg/kg/day.We excluded TM patients v.ith congenital heart disease or overtheart failure. Trans􀁆thoracal echocardiography was performed atthe Integrated Cardiac Service, CMH by a pediatric cardiologistusing the conventional method and tissue Doppler imaging (TD I)consecutively, and within 2 weeks of the subject's receiving apacked red blood cell (PREC) transfusion. The 57 TM subjectsconsisted of 19 DFO users and 38 DFP users.Results In our subjects, diastolic dysfunction was more commonlyseen than systolic dysfunction, especially moderate diastolicdysfunction. In the DFO group, diastolic dysfunction only wasdetected in 3/19 subjects, systolic dysfunction only in 1/19 subjects,and both diastolic and systolic dysfunction in 15/19 subjects. Noneof the DFO users had normal cardiac function. In the DFP group,diastolic dysfunction only was seen in 6/38 subjects, and bothdiastolic and systolic dysfunction in 30/38 subjects, while 2/38subjects had normal cardiac function.Conclusion Diastolic and/or systolic dysfunction was detected inthe majority of subjects, but with preserved global cardiac function.We found that cardiac dysfunction was not significantly different inthe two iron chelator groups. For all subjects, diastolic dysfunction was seen in 89% of cases, while systolic dysfunction was detectedin 77% of cases. [Paediatr Indones. 2012;52:272,9].

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